Login
THANK YOU FOR YOUR SUPPORT
OCT 8, 2017
The Boardwalk at 31st Street
To Benefit ALS Research & JT's Camp Grom

REGISTRATION


You are joining Team JT Walk - General Walkers (General Walker)
 
First Name:
Last Name:
Address:
City:
State:
Zip Code:
Email:
Phone:   
 
Username:
Password:
Confirm Password:
 
T-Shirt Size:
 
How did you hear about us?
 
Would you like to register additional family members today?
 
Would you like to be a Team Captain? Yes No
 
Your Fundraising Goal:
 
Select one of the participation types below:
Walker I plan to attend Walk Day
Virtual Walker I cannot attend Walk Day but still want to support.
 
Donation Information   (Same Information as Above)
Name on Credit Card:
Address:
City, State Zip:
Credit Card Number:
Security Code  What is it?
Credit Card Exp: /
Credit Card Type:
Donation Amount:
  • $50 donation per registered attendee gives you access to the Country Music Beach Party
  • $200 donation per registered attendee gives you access to the Country Music Beach Party
    in Premium VIP Seating and you will receive a personalized brick on The Camp Grom Memorial Walkway


Optional: Brick options for donations greater than $200.00
Standard Brick 4"x8" - Up to 18 Characters Per Line, Including Spaces (max. 2 lines)
Double Brick 8"x8" - Up to 18 Characters Per Line, Including Spaces (max. 6 lines)

Brick Message:
 

 
Donations to JT Walk and Beach Party are Tax Deductible (Tax ID # 261698094)
 
Follow the epic party featuring
COLE SWINDELL:   

Sponsorship Opportunities Available »